Chronic arsenic poisoning, a problem in anesthetic management

Abstract

This report presents the anesthetic considerations in a case of a patient who had chronic arsenism. A further anesthetic problem in this case was previous tracheal resection for carcinoma due to chronic arsenism. Premedication was with diazepam (15 mg), given orally two hours before operation. Intraoperative monitoring was selectively restricted to a blood pressure cuff and continuous electrocardiographic observation. The use of adhesive tape was avoided to minimize trauma to the skin. Similar considerations precluded the use of an intravenous infusion. A no. 4 black rubber anesthetic mask was applied after covering the points of facial contact with nonabrasive cotton wadding. Anesthesia was induced and maintained with 3 per cent enflurane, N2O (6 l/min) and O2 (4 l/min). A good airway was maintained without the use of an oropharyngeal device or an endotracheal tube. The patient was placed in the left lateral position and a radical excision of the mass in the chest wall was performed. The operation, postanesthetic period, and convalescence were without complication.